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Wilson C, Adams GG, Patel P, Windham K, Ennis C, Caffrey E. A Review of Recent Low-dose Research and Recommendations for Moving Forward. HEALTH PHYSICS 2024; 126:386-396. [PMID: 38568156 DOI: 10.1097/hp.0000000000001808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
ABSTRACT The linear no-threshold (LNT) model has been the regulatory "law of the land" for decades. Despite the long-standing use of LNT, there is significant ongoing scientific disagreement on the applicability of LNT to low-dose radiation risk. A review of the low-dose risk literature of the last 10 y does not provide a clear answer, but rather the body of literature seems to be split between LNT, non-linear risk functions (e.g., supra- or sub-linear), and hormetic models. Furthermore, recent studies have started to explore whether radiation can play a role in the development of several non-cancer effects, such as heart disease, Parkinson's disease, and diabetes, the mechanisms of which are still being explored. Based on this review, there is insufficient evidence to replace LNT as the regulatory model despite the fact that it contributes to public radiophobia, unpreparedness in radiation emergency response, and extreme cleanup costs both following radiological or nuclear incidents and for routine decommissioning of nuclear power plants. Rather, additional research is needed to further understand the implications of low doses of radiation. The authors present an approach to meaningfully contribute to the science of low-dose research that incorporates machine learning and Edisonian approaches to data analysis.
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Affiliation(s)
- Charles Wilson
- University of Alabama at Birmingham, School of Health Professions, Clinical and Diagnostic Sciences, Health Physics Program
| | - Grace G Adams
- Gryphon Scientific, LLC, 6930 Carrol Ave., Suite 810, Takoma Park, MD 20912
| | - Pooja Patel
- University of Alabama at Birmingham, School of Health Professions, Clinical and Diagnostic Sciences, Health Physics Program
| | - Kiran Windham
- University of Alabama at Birmingham, School of Health Professions, Clinical and Diagnostic Sciences, Health Physics Program
| | - Colby Ennis
- University of Alabama at Birmingham, School of Health Professions, Clinical and Diagnostic Sciences, Health Physics Program
| | - Emily Caffrey
- University of Alabama at Birmingham, School of Health Professions, Clinical and Diagnostic Sciences, Health Physics Program
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Takano S, Shibamoto Y, Wang Z, Kondo T, Hashimoto S, Kawai T, Hiwatashi A. Optimal timing of a γH2AX analysis to predict cellular lethal damage in cultured tumor cell lines after exposure to diagnostic and therapeutic radiation doses. JOURNAL OF RADIATION RESEARCH 2023; 64:317-327. [PMID: 36634337 PMCID: PMC10036098 DOI: 10.1093/jrr/rrac096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Phosphorylated H2AX (γH2AX) is a sensitive biomarker of DNA double-strand breaks (DSBs). To assess the adverse effects of low-dose radiation (<50 mGy), γH2AX levels have typically been measured in human lymphocytes within 30 min of computed tomography (CT) examinations. However, in the presence of DSB repair, it remains unclear whether γH2AX levels within 30 min of irradiation completely reflect biological effects. Therefore, we investigated the optimal timing of a γH2AX analysis to predict the cell-surviving fraction (SF). Three tumor cell lines were irradiated at different X-ray doses (10-4000 mGy), and the relationships between SF and relative γH2AX levels were investigated 15 min and 2, 6, 12 and 24 h after irradiation. Data were analyzed for high-dose (0-4000 mGy) and low-dose (0-500 mGy) ranges. Correlations were observed between SF and the relative number of γH2AX foci/nucleus at 12 h only (R2 = 0.68, P = 0.001 after high doses; R2 = 0.37, P = 0.016 after low doses). The relative intensity of γH2AX correlated with SF 15 min to 12 h after high doses and 2 to 12 h after low doses, with the maximum R2 values being observed 2 h after high doses (R2 = 0.89, P < 0.001) and 12 h after low doses (R2 = 0.65, P < 0.001). Collectively, cellular lethal damage in tumor cells was more accurately estimated with residual DSBs 12 h after low-dose (10-500 mGy) irradiation. These results may contribute to determination of the optimal timing of biodosimetric analyses using γH2AX in future studies.
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Affiliation(s)
- Seiya Takano
- Corresponding author. Seiya Takano, MD, Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuhocho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan. Phone: (+81)52-853-8276; Fax: (+81)52-852-5244; E-mail:
| | - Yuta Shibamoto
- Narita Memorial Proton Center, 78 Shirakawa-cho, Toyohashi, Aichi, 441-8021, Japan
| | - Zhen Wang
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Takuhito Kondo
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
- Department of Radiology, Nagoya Ekisaikai Hospital, 4-66 Syonen-cyo, Nakagawa-ku, Nagoya, Aichi 454-8502, Japan
| | - Shingo Hashimoto
- Department of Radiation Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusaku, Nagoya, Aichi 464-8681, Japan
| | - Tatsuya Kawai
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Akio Hiwatashi
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
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Kita N, Shibamoto Y, Takemoto S, Manabe Y, Yanagi T, Sugie C, Tomita N, Iwata H, Murai T, Hashimoto S, Ishikura S. Comparison of intensity-modulated radiotherapy with the 5-field technique, helical tomotherapy and volumetric modulated arc therapy for localized prostate cancer. JOURNAL OF RADIATION RESEARCH 2022; 63:666-674. [PMID: 35726342 PMCID: PMC9303627 DOI: 10.1093/jrr/rrac027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 04/04/2022] [Indexed: 06/15/2023]
Abstract
The outcomes of three methods of intensity-modulated radiation therapy (IMRT) for localized prostate cancer were evaluated. Between 2010 and 2018, 308 D'Amico intermediate- or high-risk patients were treated with 2.2 Gy daily fractions to a total dose of 74.8 Gy in combination with hormonal therapy. Overall, 165 patients were treated with 5-field IMRT using a sliding window technique, 66 were then treated with helical tomotherapy and 77 were treated with volumetric modulated arc therapy (VMAT). The median age of patients was 71 years. The median follow-up period was 75 months. Five-year overall survival (OS) and biochemical or clinical failure-free survival (FFS) rates were 95.5 and 91.6% in the 5-field IMRT group, 95.1 and 90.3% in the tomotherapy group and 93.0 and 88.6% in the VMAT group, respectively, with no significant differences among the three groups. The 5-year cumulative incidence of late grade ≥2 genitourinary and gastrointestinal toxicities were 7.3 and 6.2%, respectively, for all patients. Late grade ≥2 gastrointestinal toxicities were less frequent in patients undergoing VMAT (0%) than in patients undergoing 5-field IMRT (7.3%) and those undergoing tomotherapy (11%) (P = 0.025), and this finding appeared to be correlated with the better rectal DVH parameters in patients undergoing VMAT. Other toxicities did not differ significantly among the three groups, although bladder dose-volume parameters were slightly worse in the tomotherapy group than in the other groups. Despite differences in the IMRT delivery methods, X-ray energies and daily registration methods, all modalities may be used as IMRT for localized prostate cancer.
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Affiliation(s)
- Nozomi Kita
- Corresponding author. Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuhocho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan. Tel.: +81-52-853-8276; Fax: +81-52-852-5244; E-mail:
| | - Yuta Shibamoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
- Department of Proton Therapy, Narita Memorial Proton Center, 78 Shirakawa-cho, Toyohashi, Aichi, 441-8021, Japan
| | - Shinya Takemoto
- Department of Radiology, Fujieda Heisei Memorial Hospital, 123-1 Mizukami, Fujieda, Shizuoka, 426-8662, Japan
| | - Yoshihiko Manabe
- Department of Radiation Oncology, Nanbu Tokushukai Hospital, 171-1 Hokama, Yaese-cho, Shimajiri-gun, Okinawa, 901-0493, Japan
| | - Takeshi Yanagi
- Department of Proton Therapy, Narita Memorial Proton Center, 78 Shirakawa-cho, Toyohashi, Aichi, 441-8021, Japan
| | - Chikao Sugie
- Department of Radiology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya, Aichi, 466-8650, Japan
| | - Natsuo Tomita
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Hiromitsu Iwata
- Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City University West Medical Center, 1-1-1 Hirate-cho, Kita-ku, Nagoya, Aichi, 462-8508, Japan
| | - Taro Murai
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Shingo Hashimoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Satoshi Ishikura
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
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Ju Z, Shen L, Zhou M, Luo J, Yu Z, Qu C, Lei R, Lei M, Huang R. Helicobacter pylori and Alzheimer's Disease-Related Metabolic Dysfunction: Activation of TLR4/Myd88 Inflammation Pathway from p53 Perspective and a Case Study of Low-Dose Radiation Intervention. ACS Chem Neurosci 2022; 13:1065-1081. [PMID: 35312296 DOI: 10.1021/acschemneuro.2c00082] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Gut dysbiosis is observed in Alzheimer's disease (AD) and is frequently associated with AD-induced metabolic dysfunction. However, the extent and specific underlying molecular mechanisms triggered by alterations of gut microbiota composition and function mediating AD-induced metabolic dysfunction in AD remain incompletely uncovered. Here, we indicate that Helicobacter pylori (H. pylori) is abundant in AD patients with relative metabolic dysfunction. Fecal microbiota transplantation from the AD patients promoted metabolic dysfunction in mice and increased gut permeability. H. pylori increased gut permeability through activation of the TLR4/Myd88 inflammation pathway in a p53-dependent manner, leading to metabolic dysfunction. Moreover, p53 deficiency reduced bile acid concentration, leading to an increased abundance of H. pylori colonization. Overall, these data identify H. pylori as a key promoter of AD-induced metabolic dysfunction.
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Affiliation(s)
- Zhao Ju
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Liangfang Shen
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Meiling Zhou
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Jinhua Luo
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Zijian Yu
- The First Affiliated Hospital, University of South China, 69 Chuanshan Road, Hengyang, Hunan 421001, People’s Republic of China
| | - Can Qu
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Ridan Lei
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Mingjun Lei
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Ruixue Huang
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
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Utility of 70-kV single-energy CT in depicting the extent of breast cancer for preoperative planning. Breast Cancer Res Treat 2020; 184:817-823. [PMID: 32910319 DOI: 10.1007/s10549-020-05909-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 09/01/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the detectability of breast cancer and visibility of the tumor extent using 70-kV single-energy contrast-enhanced (CE) breast computed tomography (70-kV CECT) compared with CE breast magnetic resonance imaging (CEMR). METHODS Between 2013 and 2015, 110 patients with 112 breast cancer lesions who underwent breast surgery after undergoing both 70-kV CECT and CEMR were enrolled. The major axis lengths of the breast lesion were measured and compared with the pathologically determined major axes. Agreement in the measured major axes was evaluated using the intra-class correlation coefficient (ICC). RESULTS Both 70-kV CECT and CEMR depicted all breast cancer lesions. The mean major axis was 3.0 (95% confidence interval [CI], 2.5-3.4) cm on CECT and 2.9 (2.6-3.3) cm on CEMR. The mean differences between the pathologically and radiologically measured major axes on 70-kV CECT and CEMR were 0.9 (0.7-1.1) and 1.0 (0.8-1.2) cm, respectively. The accuracy of the radiological major axes compared with the pathological major axes was 82.1% and 80.4% on CECT and CEMR, respectively (p = 0.81). The major axes on the two modalities demonstrated moderate agreement (ICC = 0.69, 95% CI 0.58-0.77). Pathologically and radiologically measured major axes on 70-kV CECT and CEMR demonstrated excellent agreement (ICC = 0.91, 95% CI 0.93-0.96). CONCLUSIONS Low-tube voltage (70-kV) CECT is the preferred modality to identify breast cancer lesions and tumor extent for preoperative planning because it has a similar diagnostic ability to CEMR and can be performed in the supine position.
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Devic C, Ferlazzo ML, Berthel E, Foray N. Influence of Individual Radiosensitivity on the Hormesis Phenomenon: Toward a Mechanistic Explanation Based on the Nucleoshuttling of ATM Protein. Dose Response 2020; 18:1559325820913784. [PMID: 32425719 PMCID: PMC7218313 DOI: 10.1177/1559325820913784] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/02/2020] [Accepted: 02/18/2020] [Indexed: 12/16/2022] Open
Abstract
Hormesis is a low-dose phenomenon that has been reported to occur, to different extents, in animals, plants, and microorganisms. However, a review of the literature shows that only a few reports describe it in humans. Also, the diversity of experimental protocols and cellular models used makes deciphering the mechanisms of hormesis difficult. In humans, hormesis mostly appears in the 20 to 75 mGy dose range and in nontransformed, radioresistant cells. In a previous paper by Devic et al, a biological interpretation of the adaptive response (AR) phenomenon was proposed using our model that is based on the radiation-induced nucleoshuttling of the ATM protein (the RIANS model). Here, we showed that the 20 to 75 mGy dose range corresponds to a maximum amount of ATM monomers diffusing into the nucleus, while no DNA double-strand breaks is produced by radiation. These ATM monomers are suggested to help in recognizing and repairing spontaneous DNA breaks accumulated in cells and contribute to reductions in genomic instability and aging. The RIANS model also permitted the biological interpretation of hypersensitivity to low doses (HRS)-another low-dose phenomenon. Hence, for the first time to our knowledge, hormesis, AR, and HRS can be explained using the same unified molecular model.
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Affiliation(s)
- Clément Devic
- Institut National de la Santé et de la Recherche Médicale (INSERM), UA8 Unit "Radiations: Defense, Health and Environment," Centre Léon-Bérard, Lyon, France.,Fibermetrix Company, Strasbourg, France
| | - Mélanie L Ferlazzo
- Institut National de la Santé et de la Recherche Médicale (INSERM), UA8 Unit "Radiations: Defense, Health and Environment," Centre Léon-Bérard, Lyon, France
| | - Elise Berthel
- Institut National de la Santé et de la Recherche Médicale (INSERM), UA8 Unit "Radiations: Defense, Health and Environment," Centre Léon-Bérard, Lyon, France
| | - Nicolas Foray
- Institut National de la Santé et de la Recherche Médicale (INSERM), UA8 Unit "Radiations: Defense, Health and Environment," Centre Léon-Bérard, Lyon, France
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Shibata S, Shibamoto Y, Maehara M, Hobo A, Hotta N, Ozawa Y. Reasons for Undergoing CT During Childhood: Can CT-Exposed and CT-Naive Populations Be Compared? Dose Response 2020; 18:1559325820907011. [PMID: 32110172 PMCID: PMC7026821 DOI: 10.1177/1559325820907011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/22/2019] [Accepted: 01/16/2020] [Indexed: 12/20/2022] Open
Abstract
Several epidemiological studies suggested an increased risk of cancer and other tumors in individuals undergoing computed tomography (CT) examination during childhood; however, it was questioned whether the group undergoing CT was comparable to that not undergoing CT. To address this issue, we investigated the reasons for undergoing CT in 763 children aged 0 to 19 years in 2013. Their medical records were fully evaluated and symptoms, underlying conditions, reasons for CT, and clinical courses after CT were investigated. Among the 763 children, 66.1% underwent repeat CT after the first examination, and 19.3% underwent CT 8 times or more. Among all the examined children, 8.8% had cancer and 4.7% had cancer-prone conditions such as Down syndrome, tuberous sclerosis, and cirrhosis. Only 11.4% of the 763 children underwent CT because of trauma, and 32.2% of the children had some types of congenital anomaly. The rate of trauma decreased with an increase in the frequency of CT examinations. Since the incidence of congenital anomalies is below 2.5% in the general population, it was concluded that the population of children undergoing CT is completely different from that not undergoing CT. The 2 groups should not be compared.
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Affiliation(s)
- Shunsuke Shibata
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Yuta Shibamoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Megumi Maehara
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Ayano Hobo
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Naohide Hotta
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Yoshiyuki Ozawa
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Japan
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